Beauty and pleasure of growing old with a positive attitude

New York Times writer John Leland wrote a marvellous, lengthy article that was published by the Times on December 31st. Three years ago, he began following the life activity of six New Yorkers who are in their 90’s. I just loved the article and wanted to give it a “shout-out” here. Click HERE for link to read the piece for yourself. One woman told him, “What keeps me going is when you’re lively. You’ve got to be lively.You can’t be an old beckyhead.” I’m not sure what that word means, but she found a new romance at the nursing home where she must live — another resident who is also in his 90’s.

I wrote this song in honor of people like these. I call it “Two O’Clock.”

“This nursing home’s a lovely place, I walk the halls with style and grace. My sweaters match my pants and scarf. A nice red bracelet tops it off.

“They help me dress, they help me groom. I lose my way, can’t find my room. At dinnertime, they come for me. They bring me cookies with my tea.

“You think I’m just like her, or her. Aged body, mind a blur. But I’m still here, please don’t forget: I was a dancer. I’m not gone yet.

I once was up there on the stage, my name in lights on Style page. I leapt, I whirled, was caught mid-air, a bird in flight, such brilliant flair! And I performed in many halls, adored the thrill of curtain calls. I had such fans, they followed me, from town to town and big cities.

“Now every day is just the same. I can’t remember my last name. And sometimes when they look at me, I wonder what it is they see, BUT!! Two o’clock is time to dance! I’m in the limelight, it’s my chance,  to whirl, to reach, to take a bow, I was a dancer, I’m still here now. Yes two o’clock it’s time to dance, and I’m still here, it’s still my chance…  to whirl, to reach to take a bow, I AM a dancer, I’m still here now.”

 

Call for elder care planning for a good old age … 732-382-6070

 

 

Navigating the Coordination of Medicaid benefits with other benefits

Generally speaking, the Medicaid program is the payor of last resort. If an individual is eligible for Medicare as his or her primary health insurance, Medicare would be the primary payor for medical needs, and Medicaid would become the secondary payor for any remainder. If an individual maintains a “medi-gap” insurance policy, that policy would be secondary and Medicaid would be in third place. When it comes to paying for long-term nursing home care (or assisted living or home care), Medicare and most Medi-gap policies do not pay for it, so Medicaid becomes the primary payor. If an individual has a long-term care insurance policy, Medicaid would generally pay the remainder of cost, at the Medicaid rate, after the benefit provided by the LTC policy.

Interested in digging deeper into this coordination of benefits? The Centers for Medicaid and Medicare Services has published an excellent, user friendly guidebook. Enjoy!

Call us about asset protection planning, Medicaid eligibility and Fair hearings for denials of Medicaid benefits … 732-382-6070

 

 

Federal Law limits involuntary discharge of nursing home residents

The federal  Nursing Home Residents’ Rights Act protects residents against arbitrary, involuntary discharge by specifying only 6 grounds for discharge..And above all,  even when one of those 6 bases exists, a nursing home also has the duty to make a safe discharge.   A nursing home cannot involuntarily transfer a Medicaid resident unless there is another placement available which is acceptable to the Department of Health and Senior Services. NJAC 8:85-1.10(d), (e). This means that the facility cannot transfer the obligation of care to a family member of the resident who refuses to accept that obligation. The resident cannot be escorted to the door.

Discharge is limited to the following circumstances: 1.  The transfer is necessary to meet the resident’s welfare, and the resident’s welfare cannot be met in the facility. 2. The resident’s health has improved such that long term care in the institution is no longer necessary.  3. The safety of individuals in the facility is endangered.  4. The health of other individuals in the facility is endangered. 5. The resident has failed after reasonable and appropriate notice, to pay for a stay (including applying for Medicaid). 6.The facility closes.

On November 7, 2011, the Ombudsman for the Institutionalized Elderly in Trenton issued a Notice to all nursing home administrators reiterating the limited bases on which residents could lawfully be discharged, and reminding them that the notice must specifically cite one of these reasons. Here it is.Other justifications, such as behavioral problems or failure to follow facility policies, are not sufficient reasons under federal law.

The facility must provide the resident with at least 30 days written notice including the specific date of the intended discharge, unless the facility is closing, in which case, 60 days’ notice is required. Also the facility must specifically identify the exact place to which the resident will be transferred.

A Medicaid recipient or applicant would appeal the planned discharge through the Division of Medical Assistance and Health Services Fair Hearing Unit, P.O. Box 712, Trenton, NJ 08625, (609) 588-2655. A private pay resident would initiate an action for an injunction  in Superior Court, Chancery Division in the vicinage where the nursing home is located.

When it comes to senior care planning it’s vital that the family advocate become familiar with these resident’s rights. Forewarned is always forearmed.

If your loved one has received an involuntary discharge notice, spring into action. Sometimes a team meeting can resolve the problem.

Call us for representation on involuntary discharge emergencies and other nursing home issues … 732-382-6070